Drug-Drug Interactions

Treatment of HIV-associated neurocognitive disorders (HAND) is mainly through the effective treatment of HIV infection with antiretroviral drugs (refer to the treatment section). However, the guidelines from the New York State Department of Health AIDS Institute1 recommend that:

  • patients with HIV-associated dementia (HAD) may also benefit from psychotropic medications, although compared with HIV-negative individuals they are more likely to develop:
    • extrapyramidal side effects with antipsychotic agents
    • hepatotoxicity with drugs that are metabolised primarily by the liver
  • treatment of delirium should try to correct the underlying condition that led to delirium:
    • patients can be treated with low doses of antipsychotics or sedatives

Drug-drug interactions between protease inhibitors (PIs) and/or non-nucleoside reverse-transcriptase inhibitors (NNRTIs) with psychotropic drugs may lead to an increased risk of adverse drug reactions, especially in those who are older or who have more advanced disease.


  1. Office of the Medical Director, New York State Department of Health AIDS Institute in collaboration with the Johns Hopkins University Division of Infectious Diseases. Clinical Guidelines: Cognitive Disorders and HIV/AIDS. Accessed 3 March 2011.